Arthritis: Hyaluronic Acid, Collagen, Chondroitin, Bone Broth, Glucosamine, or MSM?

May 8, 2020

Arthritis: Hyaluronic Acid, Collagen, Chondroitin, Bone Broth, Glucosamine, or MSM?

Dr. Nicole Sundene

Author of "The PGE-2 Diet Program" for Pain

“Arthritis in my hands and knees is making me miserable. What should I take for my painful knees, tennis elbow, and arthritis in my hands? Glucosamine, Chondroitin, MSM, Bone Broth, Collagen, or Hyaluronic Acid?” Helen S. Scottsdale, AZ

Arthritis can be treated and prevented by taking the right joint building agents. Chondroitin, Collagen, Glucosamine, Bone Broth, MSM, and Hyaluronic Acid are great for joint health. I often use these in combination with each other and seldom see patients having adverse reactions to these supplements. Lets review the best options, the cheapest and most expensive natural arthritis formulas, as well as the actual side effects I see from prescribing them as a Naturopathic Doctor. 

NATURAL TREATMENTS FOR JOINT PAIN AND ARTHRITIS

From painful knees, to tennis elbow, shoulder pain, arthritis in the hands, TMJ, Psoriatic Arthritis, Rheumatoid Arthritis, shoulder pain, and arthritis in the hip this is a MANDATORY natural treatment for my joint pain patients that they should not skip, and at the very least use the cheapest form I will discuss today.

Whenever my patients are severely suffering from arthritic bone on bone grinding I recommend they treat their joints to the very best option they can afford. Let’s start with the best and of course most expensive arthritis choice. 

#1 ARTHRITIS SUPPLEMENT HYALURONIC ACID

Without a doubt in my mind as a doctor that relies on this for her own joint pain, as well as specializes in Autoimmunity and Natural Pain Management, the best joint support supplement for arthritis is Hyaluronic Acid. This is the #1 Cadillac choice that works the best and does the most “Extra Magic Tricks” for women. We are actually killing four birds with one stone. As we age our hair thins as does our skin, our nails become more brittle with hormone imbalance, aging, and menopause [1-3].

Hyaluronic Acid is not just for arthritis but also helps hair loss, skin, nails, facial sagging, skin sagging. Women actually pay a great deal of money in Scottsdale to shoot Hyaluronic Acid in their faces, knees, and arthritic joints. So taking Hyaluronic Acid internally can help not only with arthritis pain, and hair loss, but also thinning and sagging skin as we tend to lose the collagen behind our skin with the aging process and lack of female hormones, especially in menopause with lack of estrogen and testosterone.

HYALURONIC ACID DOSE FOR ARTHRITIS

Two caps twice daily of Hyaluronic Acid can be a game changer for arthritis and saggy skin [4, 5]. Once arthritis symptoms improve many of my patients taper the dose down to two caps once daily for cost reasons.

However, my female patients that can afford it like to stay on the 2 caps twice daily because their hair is suddenly growing like a weed. And for women it is all about their hair and skin! So this is my best anti-aging tip that is also good for your joint pain and arthritis. I personally buy the Pure Encapsulations brand in Fullscript. Be sure you are on a high quality form of this as cheap Hyaluronic Acid supplements are likely fake and therefore useless. When used correctly, I hear my patients telling me in 1-2 months their arthritis is improving or completely resolved.

SIDE EFFECTS OF JOINT SUPPORT FORMULAS FOR ARTHRITIS

After working four years in a health food store and over fifteen years as a Naturopathic Doctor I can pretty much tell you that I have heard it all when it comes to side effects. Rarely do I hear something new doing my job as a Naturopath. Since I prescribe these supplements to patients regularly I do hear occasional negative feedback about them, which means we need to switch to an alternative. 

Generally stomach ache is the main side effect of arthritis supplements. Allergic reaction is always a possibility as well. While it is possible to have a food sensitivity to different joint support, I will be reviewing my favorite options today that are less expensive than our Arthritis Cadillac… Hyaluronic Acid.

If glucosamine causes digestive upset you should take it in divided doses. Although many of my patients can stomach taking 1500mg of glucosamine all at once.

Worsening joint pain with collagen is a common side effect I hear from my Hashimotos and Autoimmune patients, because their bodies are already attacking collagen. They also describe it as "Feeling heavy, sick, and gross."

So with autoimmune arthritis, I proceed with caution using collagen, and forewarn my Autoimmune patients, which I have a ton of as a Naturopathic Doctor with an Autoimmune condition. If stomach upset is the side effect then take it with food. Never take supplements on an empty stomach unless specifically recommended by your Naturopathic Doctor.

Personally some forms of collagen make me very sick and flared up my autoimmune arthritis to a 10/10 level of pain. I have heard this tale from many other Lupus and RA patients. So when a non-autoimmune patient describes this type of reaction, I immediately think to test them for autoimmune conditions such as Hashimoto's Thyroiditis, Scleroderma, Rheumatoid Arthritis, Lupus, Sjogren's, MCTC, and so forth.

Oddly I feel great on the Vital Proteins grape gummies and snack on these as my dessert after dinner in addition to taking 2 caps of Hyaluronic Acid twice daily. That is just the arthritis system that works for my body, and keeps me away from candy and desserts! Collagen is derived from different animal sources such as beef, eggs, and fish, so one form may be okay and another may not if you have food allergies.

With that being said many of my Rheumatoid Arthritis and autoimmune disease patients feel perfectly amazing on collagen, and instantly note improvement as they build their joints back up from autoimmune attacks and inflammation. Everyone is so unique!

For whatever reason collagen tends to have the most adverse side effects reported about it so ultimately women should be using the joint support that they feel the best on. Today we will review the best available arthritis options and the appropriate dosing as not taking enough joint support is the primary reason I see joint support supplements failing.

Glucosamine theoretically may worsen blood sugar in diabetes, but I have never seen this occur in over fifteen years of using glucosamine for my arthritic diabetic patients. But it is important to be aware that it is a potential phenomena….yet that I have never seen in over fifteen years of seeing my diabetic patients on their glucosamine. 

HOW DO I KNOW MY NATURAL ARTHRITIS FORMULA IS WORKING? 

Treating arthritis naturally is a marathon and not a sprint. We cannot expect to undo years of damage suddenly in a day. Most research studies cite improvement around 6-12 weeks of implementing an arthritis formula. This is also in alignment with what I generally hear from my patients. Younger women and those with mild arthritis generally feel better after three weeks of consistent use. It is important to note your pain level when you first start taking your arthritis supplement. Keep track of any changes, and make sure the number is going down and not up. We generally track patients on a scale of 0-10 with ten being the worst pain imaginable and zero being no pain at all. 

RANT: WHY YOU SHOULD STOP ASPIRIN, IBUPROFEN, AND NAPROXEN FOR ARTHRITIS 

We need to be building the joints for arthritis and not further deteriorating them with OTC pain meds. While I do rely on some of these medications for my Lupus arthritis pain at times, as well as prescribe pain medication to my patients, they are not the best long term solution for chronic pain management. First of all, I don’t want to shame anyone that takes them, we all need them at times and I feel grateful to know they exist. For many years when I was bedridden as I tell the story in my own Autoimmune Arthritis journey, I required a lot of different types of prescription medications until I discovered the correct anti-inflammatory nutrition my body needed and began researching, creating, testing, and following my PGE-2 Diet.  

So, I would like to just start a brief tirade about the use of NSAIDS for Osteoarthritis, Rheumatoid Arthritis, and conditions with degenerative joints that chronic patients deserve to know. They need to know the truth: When used regularly  NSAIDS are actually deteriorating the joint, and doing the opposite of what joint building formulas are doing for arthritis. So if you have to take one of these OTC pain medications PLEASE also take the joint formula that you can afford and works the best for you. 

NSAIDS  (non-steroidal anti-inflammatory drugs) otherwise known as the common pain relievers that we use to treat temporary pain such as aspirin, ibuprofen, and naproxen should be taken for arthritis flare ups, and a solid Naturopathic Pain Management program using arthritis supplements, herbal medicine, and my PGE-2 Diet should be the foundation of treating arthritic pain. 

NSAIDS and heaven forbid cortisone injections (please only do this as a last resort as cortisone completely shuts down your joints ability to repair as does stress) are simply a quick fix for pain and not a great long term solution as they actually INHIBIT the synthesis of cartilage.

ARTHRITIS, ADRENALS, STRESS, AND CORTISOL CONTROL

As I explain in my Adrenal blog further about cortisol being a destructive "catabolic" hormone that destroys our joints and muscles in exchange for brief bursts of energy for emergencies. So the more stress, and rage we have the worse our arthritis is. 

Isn’t that why we have arthritis in the first place? The meniscus (shock pad between joints) is made of cartilage right? As we age it gets worn down and our joint space naturally diminishes, loses lubrication and eventually as a result we are in severe pain because we have bone rubbing on bone. Ouch!

Now that everyone is hip to the fact that NSAIDS are not a great long term solution for joint pain, let’s talk about the things that are.

If Hyaluronic Acid is not within your budget, then some of the less expensive joint formulas may be the better choice. So which one is the best?

The answer to the question of “What is better glucosamine, bone broth, collage, chondroitin, or MSM?” is “all of the above”. A good student when in doubt always picks “all of the above” or “C."

Now you could effectively choose “C” for Chondroitin and that would not be a bad answer, but Chondroitin is also pretty pricey so most people buy it with Glucosamine and MSM. Glucosamine was shown to reduce arthritis symptoms in 80% of people after just three weeks at 1500mg daily. Now 80% is FANTASTIC for any drug in a research study. So you can’t go wrong with Glucosamine on its own.

Personally I am not convinced that Glucosamine is better than Chondroitin or vice versa. So in this case we can easily choose “all of the above” because great research studies support the efficacy and safety of all three. So why not use them all together for a nice synergistic effect? Especially a great option for those with severe arthritis. You want to make sure that you are constantly topping off these nutrients that help the joints regenerate [6-12].

MSM (methylsulfonylmethane) is typically the least helpful of the three in my experience, and this research study [13]. The good thing about MSM is that it is dirt cheap so if you take a high dose diligently over the long term you will see results. Most research studies do not allow enough time realistically for improvement, and conclude falsely that these supplements do not work. The truth is they take time.

So MSM is also super cheap so in a pinch is better than nothing, and it is great for irritable bladder and the skin.

This is why many of my patients like Naturopathic arthritis formulas that contain a blend of these ingredients. But if you tend to get stomach aches, skin problems, or food sensitivities I would recommend starting with just one at a time and watching for any side effects. 

ARE HYALURONIC ACID INJECTIONS SAFE FOR ARTHRITIS? 

Yes! I am a huge fan of these injections you can get at your local Orthopedic doctor or pain management doctor. My patients generally find these injections extremely helpful and notice immediate improvements. Also many insurance companies now cover these injections, so you may even be able to get a free “Jiffy Lube” or Hyaluronic Acid injection into your deteriorated joint [13].

ARTHRITIS IMPORTANT TIP!


Rebuilding arthritic joints takes patience! Most studies note improvement at three weeks, but I think patients should plan for three months before deciding the treatment will not work. Repairing painful deteriorated joints is truly something that is going to take time. We need to rebuild collagen that has been destroyed for decades in some of my patients so expecting it to improve in a few days is not in alignment with reality. These treatments also work to improve lubrication of the painful arthritic joints. I also always recommend my patients with arthritis take a high quality omega-3 fish oil to further aid lubrication of the joint and reduce inflammation as I discuss the science and why for arthritis on that blog.

BEST ARTHRITIS REMEDY BRANDS


Be sure to buy a Naturopathic Doctor approved brand like Thorne, Vital Nutrients, Douglas Labs, Pure Encapsulations, Jarrow, Twinlab, Enzymatic Therapy, etc in Fullscript. These are the brands I buy myself and prescribe regularly to my patients. There is some concern with poor quality brands using crab and shrimp sources of glucosamine and chondroitin that are contaminated with lead. Now something that arthritis patients take daily should not have lead in it! Remember that the FDA does not regulate supplements in America so if you want your natural substance to work you need to shop smart. Many chondroitin products do not contain nearly the amount of chondroitin that they purport on the label.

When I worked four years in a health food store in the 90’s my favorite brands were Jarrow, Twinlab, and Enzymatic Therapy if you need health food store options for your arthritis. Be sure to take the full dose by the manufacturer as many of my patients are taking 25-50% of the correct dose. Double check with your Naturopathic Doctor if you can take more. For collagen powders and bone broths I recommend adding these to your smoothies, lattes, and food at 1 scoop 2-3 times daily for the first month or two. Then once the joint pain has resolved continue one scoop daily for maintenance.

#1 NUTRITION AND HERBAL TREATMENTS FOR ARTHRITIS

In addition to joint support, fish oil, and herbal medicine such as curcumin, pine, cinnamon, and ginger for arthritis, I also recommend a solid anti-inflammatory Naturopathic nutrition plan. My PGE-2 Diet is chock full of recipes to reduce pain and is perfect for women that want to treat their pain at the "Root Cause" as our nutrition can be the biggest source of inflammation in our bodies. A great deal of inflammatory molecules can come from digestion. My program is designed specifically for women in pain, or with autoimmune arthritis and provides, eight weeks of meal plans, recipes, and grocery shopping lists so women have access to exactly how I eat to manage my own autoimmune pain as I discuss in my autoimmune blog about my own battle with chronic pain.

Many of my arthritis patients also have food triggers and food sensitivities. By testing for arthritis pain trigger foods, removing them, and replacing them with the anti-inflammatory diet in my PGE-2 Diet program, we can halt inflammation driving arthritis forward, and at minimum slow the progression of the arthritis.

Women can pick up my complete Mind/Body/Spirit Naturopathic program that includes gentle yoga stretching exercises for women in pain, in addition to easy exercise videos to help improve mobility.

You can pick up the program and watch my free webinar training on how it works to help women conquer their pain, hormones, and weight gain all right here: PGE-2.com.

If you need my help with treating your arthritis with herbal medicine, testing for trigger foods and learning how to manage your pain with natural medicine simply visit my SCHEDULE page. I would be happy to help! 

Dr. Nicole Sundene

Naturopathic Medical Doctor

(480) 837-0900

Dr. Sundene is a Naturopathic Doctor in Scottsdale, Arizona, and is a Female Hormone Expert in Women's Health and Bioidentical Hormones. She specializes in Holistic Women's Health for MenopauseThyroidHashimotosPMS, Perimenopause, Autoimmune, Postpartum, Chronic Fatigue, Depression, Anxiety, Food AllergiesDigestion, Dermatology, Acne, Psoriasis,  Eczema, and Adrenal Hormonal Conditions. In 1999 she began working for a Hormone Doctor prior to starting Naturopathic Medical School. With over 23 years of experience in both Prescription and Natural women's health and hormones, she presents to women the best-integrated health solutions for their Chronic Disease. 

She has been an Herbalist for over 28 years and enjoys teaching women how to use herbs to balance their hormones, nutrition and optimize their health. Dr. Sundene relies on blood testing for her hormone metrics. The hormone testing is covered per the patient's insurance plan (not Medicaid) and conducted at certain points in the woman's menstrual cycle. To learn more about Hormone Testing for Women Visit: Bioidentical Hormones. Follow Dr. Sundene on Instagram, Twitter, and Facebook for more tips on Women's Health, Female Hormones, and Naturopathy!

References: 

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  6. 6. Kalman DS, Hewlings S. The effect of oral hydrolyzed eggshell membrane on the appearance of hair, skin, and nails in healthy middle-aged adults: A randomized double-blind placebo-controlled clinical trial. J Cosmet Dermatol. 2020 Jun;19(6):1463-1472. doi: 10.1111/jocd.13275. Epub 2020 Jan 6. PMID: 31904175; PMCID: PMC7418556.
  7. Puigdellivol J, Comellas Berenger C, Pérez Fernández MÁ, Cowalinsky Millán JM, Carreras Vidal C, Gil Gil I, Martínez Pagán J, Ruiz Nieto B, Jiménez Gómez F, Comas Figuerola FX, Aguilar Hernández ME. Effectiveness of a Dietary Supplement Containing Hydrolyzed Collagen, Chondroitin Sulfate, and Glucosamine in Pain Reduction and Functional Capacity in Osteoarthritis Patients. J Diet Suppl. 2019;16(4):379-389. doi: 10.1080/19390211.2018.1461726. Epub 2018 Apr 27. PMID: 29701488.
  8. Wang SJ, Wang YH, Huang LC. The effect of oral low molecular weight liquid hyaluronic acid combination with glucosamine and chondroitin on knee osteoarthritis patients with mild knee pain: An 8-week randomized double-blind placebo-controlled trial. Medicine (Baltimore). 2021 Feb 5;100(5):e24252. doi: 10.1097/MD.0000000000024252. PMID: 33592868; PMCID: PMC7870173.
  9. Czajka A, Kania EM, Genovese L, Corbo A, Merone G, Luci C, Sibilla S. Daily oral supplementation with collagen peptides combined with vitamins and other bioactive compounds improves skin elasticity and has a beneficial effect on joint and general wellbeing. Nutr Res. 2018 Sep;57:97-108. doi: 10.1016/j.nutres.2018.06.001. Epub 2018 Jun 9. PMID: 30122200.
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